Dr. Christina Vlahopoulos, ND
Many women who are trying to become pregnant know the importance of folic acid supplementation in the prevention of Neural Tube Defects (NTD). Government agencies have mandated that certain foods be fortified with this essential vitamin to further protect against this condition. Furthermore, it is advised by the Public Health Agency of Canada that all women planning on becoming pregnant should take 0.4mg of Folic Acid daily 3 months pre-pregnancy and for the first three months of pregnancy.
However, recent research is demonstrating that some people cannot fully use or metabolize folic acid. Even if a woman is supplementing with folic acid she may only be utilizing part of the supplement and not folic acid to its fullest extent. There are specific biochemical pathways in the body that require folic acid – for those of you interested in the biochemistry, it is the pathway from homocysteine to methionine. Essentially when homocysteine is converted to methionine, folic acid is needed for that reaction to happen. Folic acid is converted to 5-methyltetrahyrdofolate (or 5-MTHF) using and enzyme called 5,10 methyltetrahydrofolate reductase (or MTHFR). Whew! So the question then becomes what does all this biochemistry mean?
Some individuals unfortunately have what is known as a MTHFR genetic defect. The MTHFR gene plays a critical role in how folic acid is utilized in they body and with a genetic defect, the body is less able to create the active form of folic acid, 5-MTHF. 5-MTHF is a critical nutrient that can have an impact on hormone levels and detoxification just to name a few. Many people can go through life and never know they have this genetic mutation while others may experience significant symptoms – for women trying to become pregnant it could pose potential challenges.
Thankfully, vitamin and mineral supplementation is a simple way of getting the active form of folic acid and all the additional co-factors necessary for the biochemistry to do what it is supposed to. Professional supplement companies are recognizing this need and using the active form of folic acid in their formulations. For women wanting to become pregnant, women should take the active form of folic acid known as 5-MTHF or Metafolin® and take as directed by your health care professional.